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Noah and Addison frequently met in the scrub room over a period of three months, one of them always finishing surgery and scrubbing out and one scrubbing in, leading to their greeting of "Finishing or starting?".

They both continued to flirt, not knowing each other's names, and eventually met in the doctor's lounge where Noah asked for her name. Looking shocked, he quickly left, and Addison later met him as the husband of one of her pregnant patients, Morgan Gellman.

Upon this discovery, Addison quickly removed herself from Morgan's case, as she was not comfortable with her feelings for Noah while she treated his wife, feelings which Noah reciprocated. Addison, decided not to make a move in their relationship, refusing to be a home wrecker, after her past mistakes with her ex-husband and his best friend. Noah, however, asked her not to leave the case, as she was the best in her field and Morgan could not lose another child (she had a string of miscarriages prior to seeing Addison), and he would keep his feelings for Addison in check.

However, Noah could not help the way he felt, and Morgan realized her marriage was in jeopardy. She asked Addison to save her child, as that was all that was keeping her and Noah together. She said she saw it in Noah's eyes: he was there, but he wasn't quite there. When Addison had to perform surgery on Morgan, Noah was not there for her and Morgan was willing to put off the surgery to have Addison find Noah and he eventually went into the OR to be there for Morgan, with a push from Addison.